NightNurse,RN

When do you prepare for IDT? Is time allowed in your scheduled hours or on your personal time? "LookUp2Sky" if you do find specific Medicare Guidelines for IDT, please share. I have trouble with our care plans, they just seem more general than hospice specific. Anyone know a good source that is not electronic/computerized?

It is very rewarding. Especially if you like to comfort and spend time with your patients. To find out your case load, and structure of hospice team is critical. Along with if you will be salary or hourly...trust me on this...If you are salary you will not be paid for additional hours over 40 hr per week....it is highly likely that you will be putting in over that...especially with paperwork you will do at home. Also find out about on-call responsibilities...on-call duty maybe after you have already worked your scheduled 8 or 8+ hours and on weekends. Actually I make less and work more in hospice than my other nursing jobs...I can spend more time with my patients and their families than in any other discipline of nursing I have been in. My hospice team is a loving, hardworking, and overall best coworkers I have ever encountered. However, we are understaffed and tensions do run high in EOL care. Our team all starts with a morning conference call. The on-call nurse gives report, concerns addressed, updates given, and schedule changes are made. Typically our case managers are scheduled to see 5 to 7 patients a day...this includes facility and home patients. You may get called to do an admission during your scheduled 8 hours or when you are on-call. You have to take care of assigned patient load as needs arise, which involves more than your hour visit a week once or twice a week. Then every two weeks is IDT, this is where you discuss each patient you have (15 to 25), each has specific paperwork needed to report on condition and hospice eligibility. Case managers are responsible for obtaining orders, calling in medications, setting up medications, updating medications (electronically and hard chart), updating care plans, equipment, additional services, admissions, discharges, and attending funeral (not mandated). Typically weekly visits are home patients get one R.N., one L.P.N. and three S.T.N.A....more if needed in all disciplines. Facility patients get one R.N. visit and three S.T.N.A. Visit note include full head to toe assessment, care plans, comfort care given, medications, change in patient status, orders obtained, and must reflect hospice eligibility. Organization is needed...to what degree I am uncertain. Find the nurse who is most organized in your discipline...find out how she does it...find the nurse who is least organized...find out how she does it. This way you will see what works and what does not...then adjust it to you. Flexibility is essential. Your schedule will change...ALL THE TIME... Other life saving essentials... GPS and WATERPROOF MASCARA...these are a must. Hope this was helpful.

A Charge Nurse can be an R.N. or L.P.N. that is in charge of a whole facility, floor, or unit. Sometimes they also have patients and manage. If you are gonna take a charge position as a newbie ... be careful.